Historic PerspectiveThe shoulder was the first human joint to be replaced by a prosthesis. Dr. Jules E. Pean, a French surgeon, performed this operation in 1892 on a patient near death due to massive tuberculous abscess of the humerus at Hospital St. Louis in Paris. After debridement of infected bone, a prosthesis was placed made of a rubber ball attached to an iridescent platinum tube with several holes for attachment of perisoteum and muscle with horse-hair suture.1
The patient recovered and the prosthesis functioned for two years, but eventually required excision to due to chronic draining track. The prosthesis was remarkable in that it saved the patient's life, sparing him from shoulder disarticulation, and proved that it was possible to replace a joint.
Subsequent shoulder joint surgery used the proximal fibula to replace the resected proximal humerus in World War I veterans. The surrounding muscles were sutured with kangaroo tendon to the fibula.2
Modern shoulder arthroplasty began in the 1950s when Neer designed prostheses and described surgical techniques that have set the standard by which all other prostheses and techniques are judged.3
Continued design improvements and modifications have led to the increased application of shoulder arthroplasty with good long-term clinical results. Glenohumeral arthrodesis or resection is now rarely required.
Below right: Dr. Jule Pean while operating, by Henri D. Toulous-Lautrec, 1891
Below: Dr. Pean's original prosthesis, housed in the Smithsonian Institute, Division of Medical Science's National Museum of History and Technology